Stone Mountain Dental 2, PC

NPI #1548810997 in Lilburn, Georgia

Provider Information

NPI Number: 1548810997
Entity Type: Organization
Organization Name: Stone Mountain Dental 2, PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Sep 18, 2019
Last Updated: Sep 18, 2019

Practice Location

Address: 3100 FIVE FORKS TRICKUM RD SW STE 402
City: Lilburn
State: Georgia
ZIP Code: 30047-1887
Phone: (770) 837-9832

Authorized Official

Name: MS. NIKKI ROLLS
Title: PRACTICE ADMINISTRATOR
Phone: (404) 452-1164

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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